How common are rheumatic manifestations in HIV patients

How common are rheumatic manifestations in HIV patients? Has ART, previously known as highly active ART, affected this?

It is estimated that 37 million people are infected with HIV worldwide. The overall prevalence of rheumatic manifestations associated with HIV is approximately 9%. With the use of ART, the overall prevalence of SpAs, DILS, and painful articular syndrome has decreased significantly, whereas the complications of HIV and its therapy (osteopenia, avascular necrosis, and IRIS) have increased. With ART, a normal life expectancy for HIV patients can be anticipated, with increasing prevalence of chronic musculoskeletal conditions.

What are the rheumatic manifestations associated with HIV?

Pre-ART TherapyART Therapy
ArticularArthralgias (5%)HIV-associated arthritis (1%)ReAPsoriatic arthritisUndifferentiated SpAPainful articular syndrome (10%)MuscularMyalgias/fibromyalgia (30%)Polymyositis (2%)Nemaline rod myopathyInclusion body myositisHIV-wasting syndromeDILS (3%)VasculitisInfectionSeptic arthritisPyomyositisGout/hyperuricemiaIRISSarcoidosisRASLEReASjögren’s syndromeSubacute cutaneous lupusGraves’ diseaseDrug-induced conditionsZidovudine myopathyMitochondrial myopathies from newer NRTIsRhabdomyolysisGout/hyperuricemiaLipodystrophyOsseous conditionsOsteopenia/osteoporosisOsteomalaciaOsteonecrosisOsteomyelitis

NRTIs, nucleoside reverse transcriptase inhibitors; RA, rheumatoid arthritis; SLE , systemic lupus erythematosus.


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